University of Vermont

College of Medicine

Department of Surgery

Bio for Marion Couch, M.D./Ph.D./M.B.A./F.A.C.S.
Marion Couch, M.D./Ph.D./M.B.A./F.A.C.S.

Marion Couch, M.D./Ph.D./M.B.A./F.A.C.S.

Professor of Surgery
Interim Chair, Department of Surgery


Contact Information
E-mail: Marion.Couch@uvm.edu
Office Location:
111 Colchester Ave., West Pavillion, 4th Floor, Burlington, VT 05401

Education

Ph.D., Rush University, (1988)
M.D., Rush Medical College,  Chicago, IL (1990)
Residency in Otolaryngology, Johns Hopkins Hospital, Baltimore, MD (1991 – 1995)
M.B.A., Duke University, Fuqua School of Business, Executive M.B.A. Program, Concentration in Health Sector Management (2010)

Research Interests

Dr. Couch’s current research interests focuses on a severe wasting condition that may develop in patients with cancer called Cancer Cachexia. The incidence of this wasting syndrome in patients with head and neck squamous cell carcinoma (HNSCC) is thought to be as high as fifty percent in patients with advanced staged disease. The pro-inflammatory response that contributes to this loss of skeletal muscle and body fat is being studied in our laboratory. She recently completed a Phase I/II randomized, double blinded clinical trial that used non-steroidal anti-inflammatory agents to reduce the cachexia seen in these patients. Detailed body composition studies, quality of life, serum cytokine, and acute phase response levels were measured and showed promising results after only three weeks of treatment. The project is currently collecting serum samples to determine if metabolomics will allow the discovery of a unique metabolic signature – and allow a better diagnosis for patients with this severe loss of weight. Results in a murine model of cancer cachexia demonstrate that there are striking metabolic alterations in the lipid and glucose metabolism of the mice.

Dr. Couch’s laboratory has established an immunocompetent murine model of cancer cachexia for head and neck cancer. The effect of altered Toll-like receptor 4 (TLR4) signaling on the development of cancer cachexia was studied in this model and the inability of mice with a deficient TLR4 signal pathway to develop cachexia may demonstrate that there is a genetic predisposition to developing cancer cachexia, especially as it relates to mounting an inflammatory response. Future studies will look at the effect of TLR polymorphisms on the development of head and neck cancer cachexia.

Novel NF-?B inhibitors have been used to treat mice developing cancer cachexia and this shows promising results. These selective inhibitors also reverse the cardiac dysfunction seen in the cachectic mice. This work is being done in collaboration with Dr. Albert Baldwin and Dr. Monte Willis at the University of North Carolina. In addition, this is the first laboratory to discover that cancer cachexia causes significant reduction in cardiac function and structure. This is reversible with short term use of selective NF-?B inhibitors. This has important implications for cancer patients undergoing surgery or other forms of treatment and emphasizes the importance of diagnosing and treating these patients.

Academic Appointments

Interim Chair,  Department of Surgery, College of Medicine, University of Vermont, Burlington, VT 2011 - present
Associate Professor of Surgery, Division of Otolaryngology, Department of Surgery, University of Vermont, Burlington, VT  2010 - present
Associate Professor, with tenure,  Department of Otolaryngology –Head & Neck Surgery, University of North Carolina 2007 - 2010 (Joint Appointment in Department of Surgery, with tenure, Division of Plastic and Reconstructive Surgery)
Assistant Professor,  Department of Otolaryngology-Head & Neck Surgery, University of North Carolina School of Medicine 2003 - 2007
Assistant Professor, Department of Otolaryngology – Head & Neck Surgery Johns Hopkins Hospital,  Baltimore, MD  1996 – 2003  

Research Grants

University of North Carolina Program in Translational Science 
Project:Allogeneic, genetically-engineered tumor vaccine
Role:  Principal Investigator
Dates:  July 2006 – June 2008
Amount:  $266,000
Effort:  75%

Cook Critical Care Pilot Grant
Project: “Visualization of the Airway During Percutaneous
Tracheostomies Using Ultrasound.”
Role: Principal Investigator
Dates:  June 2006 – July 2008
Amount:  $3,500
Effort:  1%

American Academy of Otolaryngology – Head & Neck Surgery  
Foundation GlaxoSmithKline Clinical Research Fellowship Award
Project:  “Allogeneic Tumor Vaccines for Oral Cancer.”
Role:  Principal Investigator
Dates:  July 2005 – June 2006   
Amount:  $50,000 

Astra-Zeneca Pilot Grant
IRUSESOM0313
Project:  “Chronic Cough and Reflux Disease:  A Randomized, Double-Blinded, Placebo Controlled Trial of High Dose Proton Pump Inhibition.”
Role:  Co-investigator
Dates:  1/1/05 – 12/30/07
Amount:  $195,000  

University of North Carolina Clinical Nutrition Research Center  2005  
Research Awards Pilot and Feasibility Grant
Project: “Efficacy of Antioxidant-Depleted Diet on Cancer and Tumor Cachexia Syndrome in patients with Head and Neck Cancer”
Role: Principal Investigator

Awards and Honors

Distinguished Service Award, American Academy of Otolaryngology, Head & Neck Surgery Foundation, 2010
Who’s Who in America, 2010 - present
Academy of Educators, University of North Carolina, 2007 - present
America’s Top Doctor for Cancer, American Registry, 2005 - present

Publications

Couch ME, Dittus K, Toth MJ, Willis MS, Guttridge DC, George JR, Barnes CA, Gourin CG, Der-Torossian H. Cancer cachexia update in head and neck cancer: Definitions and diagnostic features. Head Neck. 2014 Jan 10. doi: 10.1002/hed.23599. [Epub ahead of print]

Der-Torossian H, Couch ME, Dittus K, Toth MJ. Skeletal muscle adaptations to cancer and its treatment: their fundamental basis and contribution to functional disability. Crit Rev Eukaryot Gene Expr. 2013;23(4):283-97.

Jalisi S, Sanan A, Np KM, Hussein K, Platt M, Truong MT, Couch M, Burkey BB. Economic impact of a head & neck oncologic surgeon- The case-mix index (CMI). Head Neck. 2013 Sep 3. doi: 10.1002/hed.23470. [Epub ahead of print]

Der-Torossian H, Wysong A, Shadfar S, Willis MS, McDunn J, Couch ME. Metabolic derangements in the gastrocnemius and the effect of Compound A therapy in a murine model of cancer cachexia. J Cachexia Sarcopenia Muscle. 2013 Jun;4(2):145-55.

Toth MJ, Miller MS, Callahan DM, Sweeny AP, Nunez I, Grunberg SM, Der-Torossian H, Couch ME, Dittus K. Molecular mechanisms underlying skeletal muscle weakness in human cancer: reduced myosin-actin cross-bridge formation and kinetics. J Appl Physiol (1985). 2013 Apr;114(7):858-68.

Fried D, Weissler M, Shores C, Couch M, Hayes N, Hackman T, Zanation A, Qaqish B, Chera BS. Incidence of nodal disease after nonsurgical therapy in head and neck squamous cell carcinoma patients with bilateral neck disease: can a bilateral neck dissection be avoided? Am J Clin Oncol. 2013 Apr;36(2):188-91. doi: 10.1097/COC.0b013e3182436eda.

Der-Torossian H, Gourin CG, Couch ME. Translational implications of novel findings in cancer cachexia: the use of metabolomics and the potential of cardiac malfunction. Curr Opin Support Palliat Care. 2012;6(4):446-50.

Zhao N, Ang MK, Yin XY, Patel MR, Fritchie K, Thorne L, Muldrew KL, Hayward MC, Sun W, Wilkerson MD, Chera BS, Hackman T, Zanation AM, Grilley-Olson JE, Couch ME, Shockley WW, Weissler MC, Shores CG, Funkhouser WK, Olshan AF, Hayes DN. Different cellular p16(INK4a) localisation may signal different survival outcomes in head and neck cancer. Br J Cancer 2012;107(3):482-90.

Harris SL, Thorne LB, Seaman WT, Hayes DN, Couch ME, Kimple RJ. Association of p16(INK4a) overexpression with improved outcomes in young patients with squamous cell cancers of the oral tongue. Head Neck 2011;33(11):1622-7.

Ang MK, Patel MR, Yin XY, Sundaram S, Fritchie K, Zhao N, Liu Y, Freemerman AJ, Wilkerson MD, Walter V, Weissler MC, Shockley WW, Couch ME, Zanation AM, Hackman T, Chera BS, Harris SL, Miller CR, Thorne LB, Hayward MC, Funkhouser WK, Olshan AF, Shores CG, Makowski L, Hayes DN. High XRCC1 protein expression is associated with poorer survival in patients with head and neck squamous cell carcinoma. Clin Cancer Res 2011;17(20):6542-52.

Shadfar S, Couch ME, McKinney KA, Weinstein LJ, Yin X, Rodríguez JE, Guttridge DC, Willis M. Oral resveratrol therapy inhibits cancer-induced skeletal muscle and cardiac atrophy in vivo. Nutr Cancer. 2011;63(5):749-62.

Patel SC, Carpenter WR, Tyree S, Couch ME, Weissler M, Hackman T, Hayes DN, Shores C, Chera BS. Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol. 2011;29(11):1488-94.

Couch ME, Zanation A. Transoral robotic surgery: disruptive or sustaining innovation? Arch Surg. 2010;145(9):907-8.

Seaman WT, Andrews E, Couch M, Kojic EM, Cu-Uvin S, Palefsky J, Deal AM, Webster-Cyriaque J. Detection and quantitation of HPV in genital and oral tissues and fluids by real time PCR. Virol J. 2010;7:194.

Dellon ES, Cullen NR, Madanick RD, Buckmire RA, Grimm IS, Weissler MC, Couch ME, Shaheen NJ. Outcomes of a combined antegrade and retrograde approach for dilatation of radiation-induced esophageal strictures (with video). Gastrointest Endosc. 2010;71(7):1122-9. Epub 2010 Apr 24.

Maguire PD, Papagikos M, Hamann S, Neal C, Meyerson M, Hayes N, Ungaro P, Kotz K, Couch M, Pollock H, Tepper J. Phase II Trial of Hyperfractionated Intensity-Modulated Radiation Therapy and Concurrent Weekly Cisplatin for Stage III and IVa Head-and-Neck Cancer. Int J Radiat Oncol Biol Phys. 2010 Apr 7.

Harris SL, Kimple RJ, Hayes DN, Couch ME, Rosenman JG. Never-smokers, never-drinkers: unique clinical subgroup of young patients with head and neck squamous cell cancers. Head Neck. 2010;32(4):499-503.

See more of Dr. Couch's publications on PubMed.